Surgical appliance



Nov. 23 1926.

w. L. scum suaercu. APPLIANCE Filed March 13 1.92s

2 Sheets-Sheet 1 INvEN-roR 4 ATTORNEY Patented Nov. 23, 1926,

a ILA WILLIAM L. GQULD; 0F ALBANY, NEW YORK.

SURGICAL APPLIANCE.-

Application filecl lviarch 13, 1925.

My invention relates to surgical or medical appliances and particularly to extensiondevices for use in applying tension to various parts of the body of a patient; a

The use of extensions in the treatment of fractures, dislocations, and the general stretching of nerves and muscles, is well known to physicians. lVhile apparatus is in general use, by which the direction and intensity of the tension may be varied to some extent, so far as I am aware, there is no apparatus by which gradual and positive variations in tension may be effected, or, in which gradual and positive variations in the direction of the tension may be edected without substantially varying the intensity thereof.

The objects of my invention therefore, are to provide a device of this character in which. positive and gradual variations in'the direction of the tension may be effected. Another object is to provide a'device in which gradual and'positive variations in the intensity of the tension may beefl'ected. A- further object ofmy invention isto provide a device of this character in which gradual and positive variations in the direction of the lJQIISiOIIlIlfLY be effected without substantiallyvarying. the intensity thereof. A still further object of my invention is to provide a" ments thereof as hereinafter described-and which 1 are shown in theirpreferred form in the-accompanying drawings in wh1ch Flg.1 is aside elevation. of my device showingits application to a patient;

Fig.2 is an elevation of my device viewed from the side toward the patient",

Fig. 3 is aside view of my device;

Fig. 4 is a-bottom view of Fig; 3;

Fig. 5 is an enlarged top view of'a fragv mentary portion of-Fig. 3;

Fig. 6 is asection of Fig. 5 on the line 66;

Fig. 7 is a view of a cranlnused in operating my device;

Fig. 8 is an enlarged section of my device on the line 88 of Fig. 8.

My device comprises a supporting member, 1,,whichpreferably consists of aT-shaped, plate portion, 2, adapted to be clamped to. a

crank shown in Fig.

Serial No. 15,229.

with, and'is angularly disposed to the pulley carrying member, 7. Mounted in the pulley carrying member, is the screw or worm,

8, which may be rotated by applying the to the squared'end, S), on said worm. Pulley, 10, is pivotally mounted ona'block, 11, which is threaded to receive the Worm, 8, and'which fits betwea and is prevented from turning by the portions, 12, of the pulley carrying member. Thus by rotating the worm, 8, the pulley may bemoved along the worm and variation in the distance between the pulley and the stub shaft, 6, may be positively and gradually eii'ectedby this means- Furthermore, be'causeof the low pitch of the wornr or screw, 8, no movement of the pulley can be effected by any load imparted thereto from the cable, 32, and in this way, the system is irreversible.

Mounted upon the pulley carrying member, 7, near the stublshaft, 6, is a second pulley, 13. This pulley f'med in position and is so placed that the axis of the stub shaft. is substantiallytangent to the lower surface thereof. The stubshaft, 6, extends through and projects beyond the hollow bearing, 5, as shown' at 14:, in Fig. 6. Mounted upon this projecting portion of the stub shaft, 6, is the worm wheel, 15, which is secured thereto by means of the set-screw, 16. lilieshing with the worm wheel, 15, is the worm, 1.7. The worm,17., is formed upon a hollow shaft, 18,.into which is inserted a solid shaft, 19, provided with the squared ends, 20. The shaft, 19,- is provided with bearing surfaces in the members, 21, which are preferably integral with the supporting member, 1. The squared ends of shaft, 19, are adapted to receive the crank shown in Fig. 7, and,.-it is obvious that by turning the crank, 'Z, the stud shaft, 6, may be rotated in the bearing, 5, and thus swing the pulley carrying meinber, 7, about the stub shaft as an axis. t will also be obvious that gradual and positive movements of the pulley carrying member may be thus effected.

ltfounted upon the supporting member, 1, beyond the projecting-end of the stub .sha arethe pulley, 22, and the winding drum,

set-screw,26, and the shaft, 24, is provided with hearings in the members,-4l0, which are preferably integral with the support, 1. At

tached to the drum, 23, or the shaft, 24, is

the ratchet wheel, The pawl, 29, cooperates with the ratchet wheel, and is held 111 engagement therewith by means of the tension spring, 30; The pulley, 22, and the drum, 23, are so mounted that the axis of the stub shaft is substantially tangential thereto, although they are separated suiticiently to permit a layer or two of cable to be wound upon the drum without interfering with the pulley. The drum, 23, is

provided with a small passage, 31, through which the end ofthe cable may be passed and secured by lrnotting or otherwise.

The operation of my device will be understood from a consideration of the detailed drawings, and the general illustrations in Figs. 1 and 2. A. cable, -2, which is adapted to be attached to the limb, 83, of the patient,

as shown in Fig. l is passed around the pulley, 10, the pulley, 13, through the hol low stub shaft, 6, and, where a fixed tension is desired, is attached to a weight, here a variable tension is desired, a weightis not used, but the end ofthe rope is secured in the passage, 31, ofthe drum, 23, and the tension is. obtained by winding the cable upon the drum. In either case, assuntiing a certain definite tension upon the cable, 32, it is obvious that the direction of the pull upon the limb of the patient may be gradually and positively varied by turning worm, 17. This operation will rotate the pulley carrying member in the bearing, 5, and, since a portion of the cable, 32, is substantially coaxial with the stub shaft, 6, there will be no tendency to changethe length of the cable and hence no substantial variation in the tension upon it. Where the weight, 34, is

used to provide a fixed tension, it is obvious that in addition to changing the direction of the tension upon the limb of thepatient by means of worm, 17, the direction of the tension may be varied by operating the worm, 8, without, in any way affecting the inten sity of the pull on the cable. On account of the very slow and positive motionwhich may be effected by means of the worms, it is clear that extremely delicate adjustments may be made both in the direction and in the intensity of the pull either separately or concurrently. Furthermore, since my device is essentially a single, compact unit, it may be readily transported from place to place and may be clamped to any convenient object thus enabling the surgeon to utilize it in almost any emergency.

fore to be understood that the words which I i have used in describing my device are words of description and not i of limitation, and

that changes, wi hin the scope of the appended. elanns may he made without departing from the spirit of my invention.

l i hat I claim is: a 1. A surgical extension apparatus prising a clamping plate, abearing associated with said plate, a shaft in said bearing having a pulley carrying member angularly disposed thereto, means for adjusting the" distance between said shaft and pulley, and

means for rotating said shaft in itsbearing; said mechanism being positivelyheld in ad- 3 justed position. y i i i 2. A surgical extension apparatus comprising a clamping plate,a bearing associated therewith, a shaft in said bearing having a pulley carrying member angularly disposed to said shaft, means for varying the distance between said pulley and shaft,

and means for rotating said pulley carrying member about the axis of said shaft.

3. A portable, surgical extension apparatus comprising a supporting means,.a pulley carrying means revolvable about a substantially horizontal axis associated with said supporting means, and means associatedwith the carrying means for adjusting the distance between the pulley .and the sup-1 porting means. y r

' 1. A surgical extension apparatus comprising a supporting means, a pulley carrye mg means rotatably associated therewith, means coacting wlth said carrying means for adjusting the distance betweenthe pulley and the supporting .means, and means cooperating between the pulley carrying means and thesupporting means for efl'eoting a relative rotative movement."

5. In a surgical extension apparatus, an

axially mounted, pulley carrying member provided with means coacting therewlth for positively and gradually yarying the dis tance between the pulley and the axial mounting.

6. In a surgical extension apparatus, a.

pulley carrying member, a support therefor, a winding drum on said support, for varying the tension on a cable extending over a pulley on said member and adapted to be attached to the limb of a patient, and means for gradually and positively varying the direction of the tension upon the limb without substantially varying its intensity.

7. A surgical extension apparatus comprising a support, a pulley carrying member, means for varying the tension on a cable extending over a pulley on said member and adapted for attachment ,to a pa tients limb, means for gradually and posi tively moving the pulley carrying member relative to said support without substantially varying the tension in said cable, and means independent of said first mentioned means for gradually and positively varying the tension on said cable.

8. A surgical extension apparatus comprising a support, a pulley carrying member rotatably associated therewith, a worm on said support coacting with a wheel on said member for effecting minute relative movements of said member and support; and a second worm coacting with a nut in said member for effecting minute variations in the distance between said support and a pulley on said member.

9. In a surgical extension apparatus, the combination with means for applying tension to the limb of a patient, of means for gradually and positively varying the direc tion of said tension without varying its intensity.

10. In a surgical extension apparatus, the combination with means for applying variable tension to a limb of a patient, of means for gradually and positively varying the direction of said tension through a wide angle and simultaneously varying its intensity.

11. In a surgical extension apparatus, the combination with means for applying ten sion to the limb of a patient, of means for gradually and positively varying said ten sion and means for gradually and positively varying the direction of said tension.

12. In a surgical extension apparatus, the combination with means for applying tension to the limb of a patient, of means for gradually and positively varying the direction of said tension in a plurality of directions.

13. A surgical extension apparatus comprising a plate adapted to be clamped against a vertical surface, a horizontal bearing in said plate, a pulley, a carrying member for said pulley having an angularly disposed shaft adapted to fit within said bearing and means for gradually and positively rotating said shaft in said bearin 14. A surgical extension apparatus comprising a plate adapted to be clamped against a vertical surface, a horizontal bearing onsaid plate, a pulley, a carrying memher for said pulley having an angularly disposed shaft fitted within said bearing, means for gradually and positively rotating said shaft in said bearing, and means for gradually and positively varying the distance of said pulley from said shaft.

15. A surgical extension apparatus comprising a plate adapted to be clamped against a vertical surface, a horizontal bearing on said plate, a pulley, a carrying member for said pulley having an angularly disposed shaft mounted in said bearing and means for gradually and positively varying the distance of said pulley from said shaft.

WILLIAM L. GOULD. 

